In lesions affecting both anterior and posterior ethmoids where surgery is indicated, total ethmoidectomy as part of functional endoscopic sinus surgery is the state of the art. In solo posterior ethmoid lesions, there is still controversy in terms of the most direct and least destructive approach. In these cases, it is not justified to disturb the integrity of the bulla ethmoidalis and/or the middle turbinate. In this article, a novel approach to the posterior ethmoid is presented that does not disrupt the integrity of the ostiomeatal complex.